PMH 114 Week 1-2

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PMH 114 Week 1-2
2013-04-03 20:58:00
Week test questions

Pharmacy 114
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  1. List the four lobes located in the cerebrum and explain their functions.
    • 1) Frontal Lobe - impulses for voluntary movement
    • 2) Parietal Lobe - interprets cutaneous sensations
    • 3) Temporal Lobe - auditory and olfactory area
    • 4) Occipital Lobe - vision
  2. Name the Parenteral routes of administration
    • 1) Intraocular - eye drops
    • 2) Intranasal - nose spry
    • 3) Inhalation - inhaler 
    • 4) Intravenous - direct to blood stream
    • 5) Intramuscular - Into the muscle
    • 6) Intradermal - under the skin
    • 7) Subcutaneous - beneath the skin
    • 8) Topical - ointments
  3. Name the Enteral routes of administartion
    • 1) Oral (PO)
    • 2) Buccal
    • 3) Sublingual (SL)
    • 4) Rectal (PR)

    Through the GI Trac.
  4. What are the different types of drug variation factors?
    • 1) Age
    • 2) Weight
    • 3) Gender
    • 4) Emotional state
    • 5) Genetics
    • 6) Concomitant Diseases
  5. In what way can a drug leave your body?
    • 1) Through the GI tract
    • 2) Respatory system
    • 3) Renal system
  6. List the steps in Pharmacokinetics.  What is Pharmacokinetics?
    • (ADME)
    • 1) Absorption - Drug enters the blood stream
    • 2) Distribution - Hot the chemical gets there
    • 3) Metabolism - How it breaks the chemical down
    • 4) Execration - How your body gets rid of chemicals

    Pharmacokinetics is the movement of the drug throughout the body.
  7. Explain drug naming.
    1) Chemical - scientific name, a drug can only have 1 scientific name.

    2) Brand - Proprietary name given by drug manufacturer.

    3) Generic - Active ingredient.

    4) Official - Name in references, usually generic
  8. What is direct toxicity?
    1) Reaction to medication that results in direct damage of the tissue.
  9. What is drug dependence?
    1) Patience with drug dependence need to maintain the drug to function normally.
  10. What is a Toxic Effect and what should be done?
    • 1) It is a harmful or lethal effect.
    • 2) Patient should quit taking drug.
  11. What does Narrow TI mean?
    1) It means that a patients blood levels need to monitored.
  12. What is Potency?
    1) Measurement of strength or concentration for the drug to produce a specific effect.
  13. What is the Therapeutic Index (TI)?
    • 1) Ratio of LD50 (lethal dose) and ED50 (effective dose.
    • 2) Gives relative safety of a drug
    • 3) Narrow TI
  14. List the different types of topical's.
    • 1) Cream, ointments, gels, lotions
    • 2) Powder
    • 3) Lineaments - Liquid preparation for external use that is rubbed on as a counter irritant, may produce heat.
    • 4) Trans-dermal
    • 5) Aersol
  15. What are the different types of oral medication?
    • 1) Tablet/Capsule
    • 2) Syrup
    • 3) Lozenges
    • 4) Emulsions
    • 5) Extended/Delayed Release
  16. Name the different effects of drugs
    • 1) Therapeutic Effect - Intended effect
    • 2) Side Effect - Unintended effect
    • 3) Adverse Effect - Often an exaggeration of the intended effect
    • 4)Toxic Effect - Extremely harmful effect
  17. Coordinates body movements and posture, helps maintain equilibrium.
    1) Cerebellum
  18. Group of cell bodies within the cerebrum that control certain subconscious aspects of voluntary movement.
    1) Basal ganglia
  19. Composed of myelinated axons that conduct nerve impulses to and from the cerebral cortex.
    1) Cerebral white matter
  20. Largest and uppermost part of the brain.
    1) Cerebrum
  21. Regulates sensory impulses traveling to the cortex.
    1) Thalamus
  22. Controls cardiac, vasomotor, and respiratory functions.
    1) Medulla oblongata
  23. Controls the body's higher intellectual and voluntary activities.
    1) Cerebral cortex
  24. What is an opioid?
    1) Drug that produces the same pharmacological effects as opium and its family of drugs or the neuropeptides (enkephalin, endorphin) produced by the body.
  25. Describe and antitussive effect.
    The antitussive effect is produced by direct inhibition of the coughing center in the medulla.
  26. Define opioid antagonist.
    A drug that attaches to opioid receptors and displaces the opioid analgesic or opioid neuropeptide.
  27. What is the opposite of euphoria?
  28. What is Mucus?
  29. The production of only a small amount of urine?
  30. Vomiting?
  31. The production of no urine?
  32. A substance that inhibits one's reaction to pain.
  33. Antidiuretic hormone.
  34. How do the nonopioid analgesics differ from the opioid analgesics?
    • 1) These analgesics are not chemically or structurally related to morphine.
    • 2) They are non effective against severe, sharp (visceral) pain.
    • 3) They produce analgesia through both a CNA and a peripheral mechanism of action
    • 4) They do not produce tolerance or physical dependency with chronic use.
  35. Define analgesia.
    Decreased response to pain.
  36. Explain the term inflammation.
    Condition in which tissues have been damaged, characterized by swelling, pain, heat and sometimes redness.
  37. What is joint pain?
  38. What pain is associated with muscle injury?
  39. Inflammation of the joints.
  40. Small area of skin or mucous membrane that is discolored because of localized hemorrhages.
  41. Condition in which pain and inflammation of joints are accompanied by elevated body temperature.
    Rheumatic fever
  42. Painful menstruation.
  43. Condition in which toxic doses of salicylates result in nausea, tinnitus, and delirium.
  44. What does CNS stand for?
    Central Nervous System
  45. What does PNS stand for?
    Peripheral Nervous System
  46. What are neurons?
    Basic nerve cells
  47. What are the 2 different types of neurons?
    • 1) Excitatory - transmits impulses
    • 2) Inhibitory - don't transmit impulses
  48. What is a the Synapse?
    Small gap between end of one neuron and the cell body of another.
  49. What is the Ganglion?
    Group of neuron cell bodies located outside of the CNS.
  50. Sensory or Afferent do what?
    Carry impulses from receptors to CNS
  51. What is Somatic?
  52. What is Visceral?
    Internal organs.
  53. Motor or Efferent do what?
    Carries impulses from the CNS to effectors.
  54. What do effectors do?
    The cause muscles to contract or relax
  55. What is the PNS?
    It is a combination of sensory neurons and monot neurons.
  56. What does the spinal cord do?
    Transmits impulses to and from the brain.
  57. What are the two tracts of the spinal cord and what do they do?
    • 1) Ascending tracts carry sensory impulses to the brain
    • 2) Descending tracts cary motor impulses away from the brain
  58. How may different pairs of spinal nerves are there?
  59. What is the Medulla?
    The Medulla regulates cardiac, vasomotor, and respiratory functions; reflex center for coughing, sneezing, swallowing, & vomiting.
  60. What are Pons?
    Pons work with the medulla to produce normal breathing patterns.
  61. What does the Hypothalamus do?
    It is responsible for maintaining homeostasis.
  62. What are the two divisions of the Autonomic Nervous System (ANS)?
    • 1) Sympathetic
    • 2) Parasympathetic
  63. Sympathetic and parasympathetic nervous consist of motor portions of some cranial and spinal nerves, what are they?
    • 1) Visceral - smooth muscles, cardiac muscle and glands
    • 2) Effectors - cause muscles to contract or relax
  64. What is Flight or Fight?
    It is your sympathetic neurotransmitter or adrenalin which produce both norepinephrine and epinephrine.
  65. What is AcH?
    • 1) Part of the parasympathetic system
    • 2) Inactivated by acetylcholinesterase or cholinesterase
    • 3) Reverses most of the effects of NE and EPI after flight or fight situation
  66. Why is Dopamine important in the body?
    • 1) A balance of Dopamine and AcH are responsible for fine motor movements.
    • 2) Parkinson's disease may result form dopamine deficiency.
  67. What is the chemical name for Serotonin?
  68. List 2 drugs that enhance the actions of GABA, and what do they treat?
    • 1) Benzodiazepines (BZDPs)
    • 2) Barbiturates

    They treat anxiety and seizures
  69. What are the 2 components of Pain?
    • 1) Physical
    • 2) Psychological
  70. List the factors that lower your pain threshold.
    • 1) Anxiety
    • 2) Sleeplessness, Tiredness
    • 3) Discomfort, Pain
    • 4) Anger 
    • 5) Fear, Fright
  71. List the factors that increase your pain threshold.
    • 1) Sleep
    • 2) Rest
  72. What are the 3 pain classifications?
    • 1) Acute - severe discomfort with sudden onset
    • 2) Chronic - pain that has been lasting for more than 6 months
    • 3) Psychogenic - somatic pain arising from psychiatric illness or psychosocial issues
  73. What are Opioids?
    Narcotic analgesics derived from opium or have opium-like effects.
  74. What are the 3 classifications of Opioids?
    1) Agonists - drugs that bind with the receptor to activate and produce the maximum response.

    2) Partial agonists - binds to receptor but produces a partial response

    3) Mixed agonists-antagonists - is a drug that acts as an agonist to one type of receptor and competitive antagonist at another, which produces a mixed response.
  75. What are the primary Opioid receptors in the CNS called?
    Primary opioid receptors in the CNS are the mu, kappa, delta and sigma.
  76. What are the 5 opioid agonists?
    1) Morphine (CII) - can be used in detoxification

    2) Codeine (CII) - available as oral tablets, oral solutions, and injectable dosage forms.

    3) Methadone (Dolophine) (CII) - approved for use in state approved detoxification and maintenance treatment programs.

    4) Fentanyl (CII) - Available as preservative free solution (Sublimaze) or as a topical Transdermal Patch

    5) Tramadol (Ultram) (not a controlled substance)
  77. What are Opioid Antagonists?
    Antagonists block subjective and objective opioid effects and can precipitate withdrawal symptoms in individuals physically dependent on opioids. They are used to reverse the adverse or overdosage effects of opioids and partial agonists.
  78. What are 3 specific Opioid Antagonists?
    • 1) Nalmefene (Revex)
    • 2) Naloxone (Narcan)
    • 3) Naltrexone (ReVia)
  79. What are non-opioid analgesics effective for?
    Non opioids are effective for mild to moderate pain and are often combined with opioid analgesics to enhance pain control in patients with severe pain
  80. What major drugs in the Non-Opioid class?
    • 1) ASA (asprin)
    • 2) APAP
    • 3) NASAIDS (Non-Steroidal anti-inflammatory drugs)
  81. What are some of the side effects and adverse effects of NSAIDs?
    • 1) Skin rash and pruritus
    • 2) Heartburn, nausea, vomiting
    • 3) Dizziness, drowsiness
    • 4) Gastric pain, distress or ulceration, GI bleeding, perforation
    • 5) Nephrotoxicity, tinnitus
  82. What are the contraindications to NSAIDs?
    Avoid use in patients with history of hypersensitivity or a severe allergic reaction to asprin or other NSAIDs, asthma, severe renal or liver disease, and ulcer disease.
  83. Stages of Anesthesia
    • 1) Analgesia: begins with onset and lasts until loss of consciousness.
    • 2) Excitement
    • 3) Surgical Anesthesia
    • 4) Medullary Paralysis (Toxic Stage)
  84. Special considerations for anesthesia
    • 1) Alcoholism
    • 2) Obesity
    • 3) Smoking
    • 4) Pregnancy
    • 5) Young age
    • 6) Advanced age
  85. List the inhaled anesthetics and their uses
    • 1) Gases Nitrous Oxide (N2O) - Most commonly only used agent for dental surgery, minor surgery, and obstetric analgesia.
    • 2) Volatile Liquid Anesthetics - primarily as a general anesthetic.
  86. Describe  advantages to Intravenous Anesthetics
    Intravenous Anesthetics - Advantages are rapidly induces unconsciousness, amnesic effects, prompt recovery with minimal doses, simplicity of administration, non irritating to mucos mumbranes.
  87. IV Anesthetics - Non-Barbiturates
    • 1) Benzodiazepines
    • 2) Midazolam CIV(Versed)
  88. Dissociative anesthetics
    Ketamine - dissociative anesthesia is characterized by analgesia and amnesia without loss of respiratory function or phryngeal or laryngeal reflexes
  89. Pre-anesthetics or adjunctives
    • 1) Preanesthetic agents/anesthetic adjunctive agents
    • 2) Anticholinergics: Glycopyrrolate (Robinul) - inhibition of secretions, vomiting and laryngospasms,
  90. Local Anesthetics - Topical
    Surface or topical anesthesia - commonly used are the following: Benzocaine (Americaine) Lidocaine (Xylocaine, Lidoderm) Tetracaine (Pontocaine, Synera)
  91. Anti-anxiety agents are also called?
    1) Anti-anxiety agents are also called anxiolytic agents
  92. Define Anxiety
    Anxiety is a state or feeling of apprehensions, useasiness, agitations, uncertainty and fear resulting from the anticipation of some threat or danger
  93. What have Barbiturates been replaced by?
    BZDPs - Binds to receptor adjacent to GABA receptor which results in GABA remaining at it's site.
  94. Describe ways barbiturates can be absorbed
    • 1) Oral
    • 2) Rectal
    • 3) Parenteral administration.
  95. List cautions of barbiturates
    As a class they interact with over 40 other drugs.
  96. Long Acting Amobarbital
    Used as a hypnotic for daytime sedation and for pre-op sedation.
  97. Phenobarbital
    Used as a hypnotic for daytime sedation and as a anticonvulsant; Available PO and IV, IM, SC
  98. Benzodiazepines (BZDP)
    Among the most widley prescribed drugs primarly because of their advantages over the older drugs.
  99. Benzodiazepines
    Most common indications include anxiety disorders, alcohol withdrawal, preoperative medication, insomnia, seizure disorders, and neuromuscular disease.
  100. Specific BZDPs
    • 1) Alprazolam
    • 2) Chlordiazepoxide - used in alcohol withdrawl
    • 3) Clonazepam
    • 4) Diazepam
    • 5) Flurazepam - approved as a sedative hypnotic in patients older than 16. Available PO
    • 6) Temazepam - must be over 18
  101. Benzodiazepines Antidote
    Flumazenil - indicated for treatment of BZDP overdose or to reverse the sedative effects of BZDP after surgical or diagnostic procedures.
  102. Misc Anxiolytics
    Buspirone - said to be equivalent to the BZDP bu with less sedation

    Hydroxyzine - Actually an antihistamine, it is also used as an Antianxiety agent, sedative hypnotic and antiemetic.